Senior Claims Administrator

🔥 7 hours ago

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EMC Insurance Companies

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1911

Insurance

EMC Insurance Companies is a mutual insurance firm providing specialized business insurance solutions. They focus on commercial property insurance, liability insurance, workers' compensation, and business owners' policies. With a strong emphasis on personalized service, EMC collaborates closely with local agents to deliver comprehensive and tailored coverage. EMC is committed to understanding the unique challenges faced by its policyholders, offering risk management and loss control resources to help businesses safeguard their assets. Known for their dedicated partnerships and exceptional customer service, EMC ensures that businesses are prepared for the unexpected with their superior insurance solutions.

📋 Description

• Analyzes and investigates claims to ensure compliance and timely payment of benefits • Responds to agents and policyholders regarding pending claims and appeals • Processes complex beneficiary and ownership changes and approves eligibility of waivers for life and disability income policies • Collaborates with peers and management to ensure consistent interpretations of policies and claim payment methods • Obtains reports, medical records, eligibility, and/or additional information required to investigate and process claims • Prepares filings for all life reinsurance benefits and tracks status of payments • Ensures that claims are in compliance with state and federal mandates and reviews for red flags associated with potentially fraudulent claims • Trains new claims team members and assists current claims staff with processing issues • Documents claims procedures and maintains the claims administration manual as assigned by the Claims Manager

🎯 Requirements

• Bachelor’s degree, preferably in insurance or business administration, or equivalent relevant experience • Three years of experience in life, annuity and/or health claims, or related experience • LOMA and/or International Claims Association (ICA) certifications preferred • Strong knowledge of life, annuity, WOP, contestable, and critical/chronic claims processing • Good knowledge of medical and legal terminology • Strong computer knowledge of Microsoft Suite, Outlook, Access, and insurance administration systems • Excellent verbal and written communication skills • Strong math and analytical skills • Good investigative and problem-solving abilities • Excellent organizational and customer service skills • Ability to work in a fast-paced team environment

🏖️ Benefits

• Health insurance • 401(k) plan match • Pension plan • OneEMC bonus plan • Volunteer time off annually • Professional development opportunities • Wellness initiatives • Flexibility in dress code and work arrangements